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GOLD-TMP-14

Temporal reasoning · gold-v0.1

Case inputs

As of
2026-06-08
Patient
36 years, NC
Request
Immunara for rheumatoid arthritis
Insurance
ExampleHealth, ExampleHealth Gold · EXH-671309
Policy
immunara-v0.1
Inputs
sha256:592f403549b8…

Documents 1

Physician note

clinic_note
SYNTHETIC RECORD - Example Blue Ridge Rheumatology - Office Visit - 2026-06-02
Patient reference SYN-6014. He asked today whether anything more could be done about his hand and wrist swelling, which has continued despite treatment; he works construction and reports that gripping tools has become progressively harder. He is 36 years old, was diagnosed with seropositive rheumatoid arthritis in 2022, and has been managed at this practice since.

He began oral methotrexate 20 mg weekly on 2026-02-03 and stopped it in late May after his synovitis failed to improve, an inadequate response. He has no known drug allergies and takes no other regular medications.

Given his inadequate response to methotrexate, we recommend transitioning him to Immunara.

Decisions by provider

AUTO_PROCESScorrect

Decided by: auto_process gate · auto_process 0.89

Judgments

p_yes for yes/no questions; ticks are the thresholds a gate compares each one with.

Diagnosis supported
0.970
Step therapy met
0.960
Documentation complete
0.950
Material contradiction
0.080
Missing evidence
NONE 0.710
others: TREATMENT_HISTORY 0.26 · DOSAGE 0.02 · LAB_RESULT 0.01
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=36, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.080, review at >= 0.8

  4. documentationpassed

    p_yes(documentation_complete)=0.950, request info below 0.6

  5. missing_evidencepassed

    missing_evidence=NONE (p=0.710), request info at >= 0.7

  6. auto_processFIRED → AUTO_PROCESS

    min(required p_yes)=0.950, auto at >= 0.89; p_yes(material_contradiction)=0.080, blocks at >= 0.2

  7. default_reviewnot reached

passed = the gate checked and did not fire; not reached = an earlier gate decided.

  • all required judgments are at or above 0.89 and contradiction risk is below 0.2
Run details· q-v0.2

run_20260925T170857Z_b95be9 · q-v0.2 · immunara-v0.1 (v0.1)

auto_process 0.89, chosen on gen-v0.2-dev.

questions: q-v0.2 →

Show expected answer (evaluation only)